Risk Factors for Rare Heart Condition in Delivering Mothers

Largest study of its kind identifies new risk factors for peripartum cardiomyopathy.

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Little is known about what causes peripartum cardiomyopathy (PPCM)—a rare heart condition occurring toward the end of pregnancy or in the months after delivery. This condition complicates one in every 3,000-4,000 deliveries and is difficult to study, since it occurs so infrequently. Fortunately, a recent study tapped into millions of medical records to identify key risk factors associated with PPCM and extend our understanding of this condition.

PPCM occurs when the heart muscle becomes weakened within the final month of pregnancy or within five months after delivery, and there is no known cause. Although most women recovery fully from this condition, it can cause serious complications such as cardiac arrest, need for heart transplantation and even death, in rare cases.

Published in the Journal of the American College of Cardiology, this study used hospital discharge data from 2003–2007 across six states—California, New Hampshire, New Jersey, New York, Vermont and West Virginia—to identify women with PPCM. Among more than 4 million delivery mothers included in the study, researchers found 535 patients with PPCM and compared their characteristics with those of healthy mothers. Study investigators identified many of the same risk factors that have been previously established: African-American race, being older than 30, high blood pressure, and having multiple births. They also identified new risk factors for PPCM—anemia (low red blood cell count), asthma, substance abuse and autoimmune disease—and found that women with PPCM had significantly greater risk for a stillbirth, cardiac arrest, heart transplantation, and death.

Although we have much to learn about PPCM, these findings help us better understand risk factors and outcomes associated with the condition. We can’t change some risk factors like age and race, but there are certain risk factors that we can control, such as high blood pressure and anemia. By addressing these risk factors early on, it’s possible that women can help prevent ever developing the condition and with additional research, experts hope to advance both the prevention and treatment of PPCM.

Questions for You to Consider

What causes peripartum cardiomyopathy?

Although researchers are not yet sure of the exact causes of this condition, some propose that it may be due to hormonal abnormalities, malnutrition, inflammation or immune system responses during pregnancy.

What are the signs of peripartum cardiomyopathy during pregnancy?

Although this condition is rare, it does occur in about 1 in 3,200 women. Those with peripartum cardiomyopathy will present similar symptoms as for heart failure, such as shortness of breath, chest pain and abdominal pain. Patients presenting these symptoms should talk with their doctor, as this condition can be easily diagnosed in patients.

Kimberly Binkley was diagnosed with heart failure at 39. Her heart was functioning at less than 5 percent. Today, she's an 11-year survivor committed to maintaining her heart health through exercise and diet.